Hiv and hcv coiffection: prevalence, associatedfactors and genotype characteriization in the midwest region of Brazil / Coinfecção HIV e HCV: prevalência, fatores associados e caracterização dos genótipos na Região Centro-Oeste do Brasil

A cross-sectional study on prevalence, associated factors and genotype distribution of HCV infection was conducted among 848 HIV-infected patients recruited at reference centers in the Midwest Region of Brazil. The prevalence rate of HIV-HCV coinfection was 6.9% (95% CI: 5.2 to 8.6). In multivariable analysis, increasing age, use of illicit drugs (injection and non-injection), a history of blood transfusion before 1994, and the absence of a steady partnership were significant independent associated factors for HIV-HCV coinfection. The phylogenetic analysis based on the NS5B region revealed the presence of two major circulating genotypes of HCV: genotypes 1 (58.3%) and 3 (41.7%). The prevalence of HIV-HCV coinfection was lower than those reported in studies conducted with HIV-infected patients in different regions of Brazil, due to the fact that illicit drug use is not a frequent mode of HIV transmission in this region of Brazil. Serologic screening of HIV-patients for HCV before initiating antiretroviral treatment, a comprehensive identification of associated factors, and the implementation of effective harm reduction programs are highly recommended to provide useful information for treatment and to prevent HCV coinfection in these patients.

Estudo transversal sobre a prevalência, fatores associados e distribuição dos genótipos do HCV foi realizado em 848 pacientes infectados pelo HIV, recrutados em centros de referência na Região Centro-Oeste do Brasil. A taxa de prevalência de coinfecção HIV-HCV foi de 6,9% (IC 95%: 5,2-8,6). Na análise multivariada, o aumento da idade, o uso de drogas ilícitas (injetáveis e não injetáveis), história de transfusão de sangue antes de 1994, e ausência de companheiro constante foram fatores associados independentes e significativos para a coinfecção HIV-HCV. A análise filogenética baseada na região NS5B revelou a presença de dois principais genótipos do HCV em circulação: genótipos 1 (58,3%) e 3 (41,7%). A prevalência da coinfecção HIV-HCV foi menor do que as relatadas em estudos realizados com pacientes infectados pelo HIV em diferentes regiões do Brasil, devido ao fato de que o uso de drogas ilícitas não é modo frequente de transmissão do HIV neste Estado do Brasil. Triagem sorológica de pacientes HIV-positivos para HCV antes de iniciar o tratamento antirretroviral, identificação completa dos fatores associados e a implementação de programas eficazes de redução de danos são altamente recomendados para fornecer informações úteis, para o tratamento e para evitar a coinfecção com HCV nestes pacientes.

Pertussis in the central-west region of Brazil: one decade study

In many parts of the world, numerous outbreaks of pertussis have been described despite high vaccination coverage. In this article we report the epidemiological characteristics of pertussis in Brazil using a Surveillance Worksheet. Secondary data of pertussis case investigations reported from January 1999 to December 2008 recorded in the Information System for Notifiable Diseases (SINAN) and the Central Laboratory for Public Health (LACEN-MS) were utilized. The total of 561 suspected cases were reported and 238 (42.4%) of these were confirmed, mainly in children under six months (61.8%) and with incomplete immunization (56.3%). Two outbreaks were detected. Mortality rate ranged from 2.56% to 11.11%. The occurrence of outbreaks and the poor performance of cultures for confirming diagnosis are problems which need to be addressed. High vaccination coverage is certainly a good strategy to reduce the number of cases and to reduce the impact of the disease in children younger than six months.